关键词: 卵巢甲状腺肿, 临床病理特征, 诊断

Abstract: Objective To investigate the clinicopathology features of benign and malignant struma ovarii (SO) and analysis the diagnosis and treatment. Methods The ages, symptoms, signs and other general data of 80 patients with benign SO and 13 patients with malignant SO confirmed by surgery and pathology were collected from March 2009 to August 2021 in Beijing Obstetrics and Gynecology Hospital, Capital Medical University and Beijing Chaoyang Integrative Medicine Emergency Medical Center. Ultrasound examination and serum tumor marker test were performed. Both benign and malignant SO patients received surgical treatment. The diagnosis was confirmed by routine postoperative pathological analysis of the gross mass and paraffin hematoxylin-eosin(HE) staining. For malignant patients, The International Federation of Gynecology and Obstetrics (FIGO) staging was performed according to surgical pathology and supplementary treatment was performed according to National Comprehensive Cancer Network (NCCN) guidelines. Results The majority of SO patients did not show obvious clinical symptoms, most of which occurred in unilateral ovary. The ultrasound findings were nonspecific and often showed regular multilocular cystic solid masses. All 13 patients with malignant SO were stage I ovarian thyroid carcinoid. Among the 15 patients who underwent immunohistochemical test, thyroid transcription factor-1(TTF-1) and thyroglobulin (TG) were positive, and Ki67 expression level was low. Only 16 patients (20%) in benign SO had elevated tumor markers, while carbohydrate antigen 199(CA199) levels of 3 patients (23.08%) in malignant SO had slightly elevated. Laparoscopy is the main approach for benign SO surgery, and 41 patients (51.25%) underwent ovarian cystectomy. Transabdominal surgery is the main approach for malignant SO surgery, only 5 cases (38.46%) were performed with ovarian tumor staging, and 4 patients received postoperative supplementary chemotherapy. Conclusion The incidence of SO is low. The clinical manifestations, ultrasound and serum tumor markers are not specific. Patients with ascites are more likely to be confused with epithelial ovarian malignancy. SO profile typically showed multilocular cystic solid, containing gelatinous objects and remote hemorrhage focus, and the texture was not bad and brittle. Surgical resection is the main diagnostic method and treatment.

Key words: struma ovarii, clinicopathology features, diagnosis